Alaska Natives (AN) have the highest prevalence rates of tobacco use among ethnic minorities in the United States. The rates of tobacco use are particularly high among Alaska Native youth residing on in rural Alaska. In the State of Alaska 2003 Youth Risk Behavioral Survey 45% of AN youth use cigarettes and 25% use smokeless tobacco (ST). The only increase in tobacco use prevalence in the BRFSS, YRBS and PRAMS in 2003, is among AN high school girls who use ST. Reports from our prior focus group work with Alaska Natives indicate that many children are exposed to tobacco in utero, and Iqmik may be used regularly by children as young as 3 years old. In a study conducted among AN children and adolescent in Western Alaska, we found the prevalence of ever and current use of tobacco increased steadily with age. Of children 6-10 years of age, 25% reported having tried tobacco. In contrast, the prevalence rates of alcohol and other drug use were very low. AN adolescents who use tobacco are at high risk for future tobacco-related morbidity and mortality. Cancer-related mortality has increased among AN.7,8 However, tobacco cessation interventions developed for AN adolescents do not exist. Thus, formative work conducted jointly with AN youth is needed to develop and test interventions that are feasible and culturally appropriate and acceptable. As an initial step toward demonstrating the acceptance of culturally-tailored interventions that are effective for AN youth, it is important to assess their preferences for interventions. This proposal builds on our previous focus group work with AN adolescents. The adolescents expressed interest and desire to stop using tobacco. The adolescents perceived a lack of availability of resources, education, or counseling about how to stop tobacco use. Some reported learning that adults had stopped using tobacco with the nicotine patches or gum or on their own, but the participants had never seen medications to stop using tobacco. The Alaska Native Tribal Health Consortium developed a culturally specific video series targeted toward Alaska Native youth who use tobacco, entitled the "Challenge to Quit". These videos feature personal stories of Alaska Natives who have suffered from 1) a tobacco related disease; 2) loss of a loved one from a tobacco related disease; 3) currently suffer from a tobacco related disease. The videos are designed to be used in a series that is facilitated by an adult trained to facilitate the teens feelings about tobacco before, during and after viewing the each video or a timeline of weeks, as part of a cessation protocol. The design of that protocol would be derived from information learned in this proposed study. [unreadable] [unreadable] [unreadable]